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Cheilectomy is surgery to remove a bony lump that has formed above the main joint of the big toe. This lump is usually caused by big toe arthritis (also known as hallux rigidus).
What does cheilectomy involve?
Cheilectomy can be carried out as a day case procedure while you are under a general anaesthetic. You will also be given a local anaesthetic into the foot to reduce pain after the procedure.
You can help improve the outcome of surgery by attending a pre-assessment screening where you’ll have blood tests to check for levels of Vitamin D and swabs to rule out infection or other problems. You’ll also be weighed and have an opportunity to discuss your medical history. This is important so that any anaesthetics problems can be identified.
Please note: it’s important to stop smoking at least eight weeks before your procedure; this is because smoking can affect the body’s ability to heal and causes health problems including an increased risk of blood clots forming in the lungs (pulmonary embolism) or calf (deep vein thrombosis).
What happens after surgery?
Your foot will be numb and pain-free (from a local anaesthetic injection around the affected area). A member of our physiotherapy team will help you to stand, supported by crutches, and will give you a tailored programme of exercises to help you walk correctly in a padded stiff shoe that supports your toe. In most cases, you’ll be given painkillers to take for a few days and offered a follow-up appointment with Mr Heidari.
How can I speed up my recovery?
Raising your foot above the level of your heart and keeping weight off the foot as much as possible during the first few days can help with recovery. You may also be advised to take anti-inflammatory painkillers. Make sure you follow any advice about keeping the wound clean and dry, and carry out the exercises advised by your physiotherapist as these will help you to return to your normal activities as quickly as possible.
When can I drive again?
The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is when you can stamp down hard with the foot to stop the car during an emergency stop. How long this takes will vary, depending on how quickly you recover.
Although Mr Heidari will advise you about when it’s safe to start driving again, it is your own responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.
When can I return to work?
This varies, depending on the type of work you do and the speed of your recovery. In most cases, if you have a sedentary job (sitting down most of the time), you should be able to return after around two weeks. If your job involves manual work, you may need up to four weeks off.
What is the long term outcome of surgery?
Following the exercises prescribed by your physiotherapist, you should gradually be able to return to your everyday activities over the three months following your surgery. Most people don’t have any further problems (although this may depend how seriously damaged the toe was before surgery).
What are the risks of this type of surgery?
- All surgery carries risks. With this type of surgery, risks include a small chance of infection which can be treated with antibiotics
- There is a small chance of deep vein thrombosis (DVT) following any surgery, although this is unusual following this type of surgery. However, you may be given blood-thinning medication after surgery as a precaution or if you are at higher risk. You will also be given support socks and exercises to reduce the chances of DVT
- There is also a small chance of nerve damage which can cause temporary or permanent numbness around the toe